“I’m going to check on my patients,” David said. He shook a finger at Nikki. “I won’t be long, and no terrorizing the nurses, promise?”
“Promise,” Nikki said, then she giggled with Caroline.
David headed straight for Donald Anderson’s room. He wasn’t worried about Donald’s status because he’d called to check on him throughout the day. The reports had always been the same: the blood sugars were all normal and the GI complaints had decreased.
“How are you, Donald?” David asked as he arrived at the bedside.
Donald was on his back. His bed was raised so that he was reclining at a forty-five-degree angle. When David spoke he slowly rolled his head to the side, but he didn’t answer.
“How are you?” David said, raising his voice.
Donald mumbled something David couldn’t understand. David tried again to talk with him, but quickly realized that the man was disoriented.
David examined him carefully. He listened intently to his lungs, but there were no adventitious sounds, indicating that his lungs were clear. Walking out to the nurses’ station he ordered a stat blood sugar.
While the blood sugar was being processed, David saw his other patients. Everyone else was doing well, including Sandra. Although she’d been on antibiotics for less than twelve hours, she insisted the pain in her jaw was better. When David examined her, his impression was that the abscess was the same size, but the symptomatic improvement was encouraging. He did not change her treatment. Two other patients were doing so well he told them they could go home the following day.
As he was finishing his entry in the chart of his last patient, the floor secretary slipped the result of Donald’s blood sugar under David’s nose. It was normal. David picked up the scrap of paper and studied it. He didn’t want it to be normal. He wanted it to explain the change in Donald’s mental status.
David slowly walked back to Donald’s room, puzzling over his condition. The only explanation that David could think of was that Donald’s blood sugar had had a wild swing either up or down and had then corrected itself. The problem with that line of reasoning was that the patient’s sensorium usually returned to normal simultaneous with the blood sugar.
David was still mulling over the possibilities when he reentered Donald’s room. When he first saw Donald, David stared in utter disbelief. Donald’s face was dusky blue and his head was thrust back in hyper-extension. Dark blood oozed from a half-open mouth. His body was only partially covered; the bedcovers were in total disarray.
David’s initial shock quickly turned into motion. He alerted the nurses that there had been an arrest and started cardiopulmonary resuscitation. The resuscitation team arrived and followed their familiar routine. Even Donald’s surgeon, Dr. Albert Hillson, came in. He’d been making round’s when he’d heard the commotion.
The resuscitation attempt was soon called off. It was apparent that Donald had suffered a seizure and respiratory arrest somewhere between fifteen and twenty minutes prior to David finding him. With that amount of time having passed with no oxygen getting to the brain, there was no hope. David declared Donald dead at five-fifteen.
David was devastated at having lost yet another patient, but he forced himself not to show it. Dr. Hillson was saddened but expansive. He said that it had been a tribute to good medical care that Donald had lived as long as he had. When Shirley Anderson came in with her two young boys, she voiced the same sentiment.
“Thank you for being so kind to him,” Shirley said to David as she blotted her eyes. “You had become his favorite doctor.”
After David had done all he could, he headed toward Caroline’s room to get Nikki. He felt numb. It had all happened so quickly.
“At least you know why this patient died,” Angela said after David had described what had happened to Donald Anderson. They were sitting in the family room. Dinner was long since over; Nikki was up in her room doing her homework.
“But I don’t,” David complained. “It all happened so fast.”
“Now, wait a minute,” Angela said. “With the other patients I could understand your confusion. But not with this one. Donald Anderson had had most of his abdominal organs rearranged if not removed. He was in and out of your office and the hospital. You can’t possibly blame yourself for his death.”